Brachial plexus injury following spinal surgery

A review

Juan S. UribeDepartments of Neurological Surgery,

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 M.D.
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Jaya KollaTampa General Hospital;

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 M.D.
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Hesham OmarTampa General Hospital;
Department of Cardiology, Cairo University, Cairo, Egypt

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 M.D.
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Elias DakwarDepartments of Neurological Surgery,

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 M.D.
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Naomi AbelNeurology,

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 M.D.
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Devanand MangarTampa General Hospital;
Neurology,

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 M.D.
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Enrico CamporesiNeurology,
Surgery,
Anesthesiology, and
Molecular Pharmacology and Physiology, University of South Florida;

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Object

In the present study, the authors identified the etiology, precipitating factors, and outcomes of perioperative brachial plexus injuries following spine surgery.

Methods

We reviewed all the available literature regarding postoperative/perioperative brachial plexus injuries, with special concern for the patient's position during surgery, duration of surgery, the procedure performed, neurological outcome, and prognosis. We also reviewed the utility of intraoperative electrophysiological monitoring for prevention of these complications.

Results

Patient malpositioning during surgery is the main determining factor for the development of postoperative brachial plexus injury. Recovery occurs in the majority of cases but may require weeks to months of therapy after initial presentation.

Conclusion

Brachial plexus injuries are an increasingly recognized complication following spinal surgery. Proper attention to patient positioning with the use of intraoperative electrophysiological monitoring techniques could minimize injury.

Abbreviations used in this paper:

EMG = electromyographic; MEP = motor evoked potential; SSEP = somatosensory evoked potential.
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